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Objective To study the influence of carbon dioxide pneumoperitoneum on BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy in propofol and sevoflurane anesthesia. Methods 100 cases undergoing laparoscopic hysterectomy were selected in the second hospital of Shandong university and were divided into group A and group B, 50 cases in each group. Group A were received propofol and group B were received sevoflurane anesthesia . The oxygen metabolism index in the two groups were compared before and after pneumoperitoneum. Results The PETCO2 of two groups at the time points after pneumoperitoneum were significantly higher than those before pneumoperitoneum (P<0.05). There was no significant difference of the SpO2 in two groups at the different time points during pneumoperitoneum, The HR and MAP of the group A were significantly lower than that of group B (P<0.05). There were no significant difference of the PETCO2、SpO2 between two groups. Bis in 2 groups maintained a stationary state before and after pneumoperitoneum. There was no significant difference in the period between the two groups. The CjvO2、Lac of two groups were significantly higher than that before pneumoperitoneum (all P<0.05).The CjvO2、Lac of two groups were significantly lower than that before pneumoperitoneum (all P<0.05). The CjvO2 of group A at 40 minutes after pneumoperitoneum were higher than that of group B (P<0.05), and the level of CERO2、Da-jvO2 were lower than that of group B (P<0.05). But there were no difference of the BIS、CaO2 and Lac between two groups. Conclusion Carbon dioxide pneumoperitoneum can affect the BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy. The effect in propofol anesthesia was more significant than that in sevoflurane anesthesia.
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Objective To investigate the effects of combination of propofol and whole-body hypoxic preconditioning on lung ischemia-reperfusion(I/R)injury in rats and the mechansim involved.Methods Ninety male SD rats weighing 250-320 g,were randomly divided into 5 groups(n=18 each): sham operation group(group S),lung I/R group(group I/R),propofol preconditioning group(group P),whole-body hypoxic preconditioning group(group WBHP),and combination of propofol and whole-body hypoxic preconditioning group(group PW).The animals were anesthetized with intraperitoneal 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated.Lung I/R injury was produced by occlusion of hilum of the left lung for 45 min followed by reperfusion.Propofol was continuously infused iv at 30 mg·kg-1·h-1 30 min before ischemia in group P.In group WBHP,5 times of WBHP were performed before ischemia.In group PW,propofol was infused iv at 30 mg· kg-1·h- 1 and 5 times of WBHP were performed 30 min before ischemia.Six rats from each group were killed at 30 min,1 h,and 4 h of reperfusion(T1-3).The lungs were then removed for determination of the contents of TNF-α,IL-1,IL6 and MDA,and activities of SOD.The W/D lung weight ratio was calculated.Results Compared with group S,the contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly increased at T1-3,and SOD activity was significantly decreased at T1-3 in the other four groups(P＜0.05).The contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly lower at T1-3 ,and SOD activity was significantly higher at T1-3 in group P,WBHP and PW than in group I/R(P ＜ 0.05).The contents of TNF-α and IL-6 and W/D ratio at T2,3 and contents of IL-1 and MDA at T3 were significantly lower,and SOD activity was significantly higher at T2,3 in group PW than in group P and WBHP(P＜0.05).There was no significant difference in the parameters metioned above between group P and WBHP(P＞0.05).Conclusion The combination of propofol and WBHP can protect the lungs from I/R injury,the efficacy is better than that of either of them alone,and it may be related to the enhancement in the inhibiton of inflammatory reaction and improvement in the antioxidant effect.
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Objective To compare the effects of sevoflurane and propofol anesthesia on inflammatory response and pulmonary function during perioperative period in patients undergoing lung cancer resection．MethodsThirty ASA Ⅰ or Ⅱ patients(23 male，7 female) aged 41-64 yr having a body weisht index of 22-30 kg/m2 undegoing elective left lower lobe resection were randomlydivided into 2 groups(n=15 each)：sevoflurane group (group S) and propofol group(group P)．Anesthesia was induced with 6％-8％ sevoflurane or propofol 2 mg/kg and fentanyl 4-6 μg/kg．Intubation with double lumen catheter was facilitated with vecuroniunl 0．1 mg/kg． Anesthesia was maintained with 1％-3％ sevoflurane/propofol infusion(6-10 mg·kg-1·h-1)and intermittent iv boluses of fentanyl and vecuronium．Radial artery was cannulated．Swan-Ganz catheter was placed via right internal jugular vein．The patients were mechanically ventilated．During one lung ventilation(OLV)I：E and VT were adjusted to maintain airway pressure <30 cm H2O．Arlerial and mixed venous blood samples were collected for blood gas analysis before induction of anesthesia(T0)，before OLV(T1)，at the end of OLV(T2)，when the chest was closed(T3) and at 24 h after operation (T4)．PA-aO2，Qs/Qt and respiratory index(RI，PA-aO2/PaO2) were calculated. Serum matrix metallo-proteinase-9 (MMP-9) and MDA were measured at T0, T3 and T4. Dynamic lung compliance (Cd) was calculated at T1-3 .Results PA-aO2, RI and Qs/Qt at T1-3 and serum MMP-9 and MDA concentrations at T3 were significantly increased as compared with the baseline values at T0 in both groups. In group S, Cd was significantly lower at T3 than at T1.PA-AO2, and serum MMP-9 and MDA concentrations at T3, RI at T2,3 and Qs/Qt at T1-3 were significantly higher in group S than in group P. Conclusion The inflammatory response is lower and the injury to pulmonary function is lighter during propofol anesthesia than sevoflurane anesthesia in patients undergoing lung cancer resection.